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Uric acid in renal transplants

Maria L Reina de la Torre, Herminia Lopez García de la Serrana, Loreto Martí Del Moral, Magdalena Palomares Bayo, Miguel Navarro-Alarcón
The regulation of mineral homeostasis is altered in hemodialysis patients with renal insufficiency, producing increased risk for secondary diseases like cardiovascular ones. We hypothesized that risen serum aluminum (Al) concentration in hemodialysis patients kept enhanced during a 2-year longitudinal study is associated with enhanced cardiovascular risk and influenced by medical treatments. This study reports the prospective monitoring of serum Al levels in six-monthly samplings over 2 years in 116 hemodialysis patients and a control group of 50 healthy adults...
November 30, 2016: Biological Trace Element Research
Pierre-Antoine Juge, Marie-Elise Truchetet, Evangeline Pillebout, Sébastien Ottaviani, Cécile Vigneau, Clotilde Loustau, Divi Cornec, Tristan Pascart, Renaud Snanoudj, Florian Bailly, Emilie Cornec-Le Gall, Thierry Schaeverbeke, Alain Saraux, Philippe Dieudé, René-Marc Flipo, Pascal Richette, Frédéric Lioté, Thomas Bardin, Gérard Chalès, Hang-Korng Ea
OBJECTIVES: The allopurinol dose is limited in chronic kidney disease, particularly stage 4/5 chronic kidney disease. Febuxostat has a hepatic metabolism and has been approved without dose adaptation in gouty patients with stage 1-3 chronic kidney disease. We aimed to study the safety and efficacy of febuxostat for stage 4/5 chronic kidney disease. METHODS: In this retrospective study, we included patients with (1) a diagnosis of gout, (2) febuxostat treatment, (3) estimated glomerular filtration rate≤30mL/min/1...
November 4, 2016: Joint, Bone, Spine: Revue du Rhumatisme
Louis J Imbriano, Joseph Mattana, James Drakakis, John K Maesaka
BACKGROUND: There is controversy over the prevalence of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and cerebral or renal salt wasting (RSW), 2 syndromes with identical common clinical and laboratory parameters but different therapies. The traditional approach to the hyponatremic patient relies on volume assessment, but there are limitations to this method. METHODS: We used an algorithm that relies on fractional excretion of urate (FEurate) to evaluate patients with hyponatremia and present 4 illustrative cases...
October 2016: American Journal of the Medical Sciences
Hyun Seon Kim, Sun Woo Lim, Long Jin, Jian Jin, Byung Ha Chung, Chul Woo Yang
BACKGROUND: The use of calcineurin inhibitors is a well-known risk factor for hyperuricemia in kidney transplant recipients. We evaluated the effect of febuxostat (Fx), a new uric acid-lowering drug, on hyperuricemia and renal injury in an experimental model of chronic tacrolimus (Tac)-induced nephropathy. METHODS: Chronic Tac nephropathy was induced by administering Tac (1.5 mg/kg/day) to rats on a low-salt diet (0.05%) with oxonic acid (OA, 2%, 0.2 g/kg/day) for 28 days...
October 5, 2016: Nephron
Narayan Prasad, Akhilesh Jaiswal, Vikas Agarwal, Shashi Kumar, Saurabh Chaturvedi, Subhash Yadav, Amit Gupta, Raj K Sharma, Dharmendra Bhadauria, Anupama Kaul
BACKGROUND: We aimed to longitudinally analyse changes in the levels of serum fibroblast growth factor 23 (FGF23), intact parathyroid hormone (iPTH) and associated minerals in patients undergoing renal transplantation. METHODS: Sixty-three patients with end-stage renal disease (ESRD) who underwent living donor transplantation were recruited. Serum FGF23, iPTH, uric acid, inorganic phosphorous (iP), blood urea nitrogen and serum creatinine were measured pre-transplant and at 1 (M1), 3 (M3) and 12 months (M12) post-transplantation...
October 2016: Clinical Kidney Journal
Giovanni Mosconi, Giulio Sergio Roi, Valentina Totti, Marco Zancanaro, Alessandra Tacconi, Paola Todeschini, Eric Ramazzotti, Rocco Di Michele, Manuela Trerotola, Carlo Donati, Alessandro Nanni Costa
BACKGROUND: A few patients, after receiving solid organ transplantation, return to performing various sports and competitions; however, at present, data no study had evaluated the effects of endurance cycling races on their renal function. METHODS: Race times and short form (36) health survey questionnaires of 10 kidney transplant recipients (KTR) and 8 liver transplant recipients (LTR) transplanted recipients involved in a road cycling race (130 km) were compared with 35 healthy control subjects (HCS), also taking laboratory blood and urine tests the day before the race, at the end of the race, and 18 to 24 hours after competing...
October 2015: Transplantation Direct
Smiley Annie George, Sulaiman Al-Rushaidan, Issam Francis, Darius Soonowala, M R Narayanan Nampoory
Adenine phosphoribosyltransferase deficiency is a rare autosomal recessive disorder of uric acid metabolism that leads to formation and excretion of 2,8-dihydroxyadenine into urine. The low solubility of 2,8-dihydroxyadenine results in precipitation and formation of urinary crystals and renal stones. Patients with this disorder usually have recurrent nephrolithiasis and can develop nephropathy secondary to crystal precipitation in the renal parenchyma. The disease is most often underdiagnosed and can recur in renal transplant, causing graft failure...
July 22, 2016: Experimental and Clinical Transplantation
M Vignon, V Javaugue, M P Alexander, K El-Karoui, A Karras, D Roos-Weil, B Royer, B Asli, B Knebelmann, G Touchard, A Jaccard, B Arnulf, F Bridoux, N Leung, J P Fermand
We retrospectively reviewed 49 patients with light-chain (LC) Fanconi syndrome. Patients presented with chronic kidney disease (median estimated glomerular filtration rate (eGFR) of 33 ml/min/m2) and tubular proteinuria. All patients tested had elevated fractional excretion of phosphate, uric acid, generalized aminoaciduria and/or normoglycemic glycosuria. Thirty-eight patients had monoclonal gammopathy of renal significance and 11 patients had an overt hematological malignancy. The monoclonal LC isotype was kappa in 46/49 cases...
July 20, 2016: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
Nikolaos Pagonas, Samad Kor, Felix S Seibert, Arnd Giese, Walter Zidek, Petra Reinke, Nina Babel, Frederic Bauer, Timm H Westhoff
BACKGROUND Hyperuricemia is very common after renal transplantation. It is associated with an increased risk of cardiovascular events and graft loss. To date, however, treatment is only recommended in symptomatic disease. MATERIAL AND METHODS We included 503 adult patients who underwent kidney transplantation at the Charité-Universitätsmedizin Berlin in this retrospective study. Patients were followed up for up to 120 months. All-cause mortality, graft survival, changes in level of serum uric acid (SUA), and estimated glomerular filtration rate (eGFR) were analyzed...
June 7, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
G Mosconi, M L Angelini, W Balzi, V Totti, G S Roi, M Cappuccilli, M Tonioli, D Storani, M Trerotola, A N Costa
BACKGROUND: Few solid-organ-transplanted patients (TP) perform regular sport activity. Poor data are available on the safety of intense and prolonged physical exercise on this population. The aim of the study was to evaluate kidney function parameters in a group of TP in comparison with healthy volunteers (HV) involved in a long-distance road cycling race: length 130 km and total uphill gradient, 1871 m. METHODS: Nineteen TP were recruited: 10 renal, 8 liver, and 1 heart and compared with 35 HV...
March 2016: Transplantation Proceedings
Yusuke Okabayashi, Izumi Yamamoto, Yo Komatsuzaki, Takahito Niikura, Takafumi Yamakawa, Haruki Katsumata, Mayuko Kawabe, Ai Katsuma, Yasuyuki Nakada, Akimitsu Kobayashi, Yusuke Koike, Jun Miki, Hiroki Yamada, Yudo Tanno, Ichiro Ohkido, Nobuo Tsuboi, Kimiyoshi Ichida, Hiroyasu Yamamoto, Takashi Yokoo
We report a rare case of nephrocalcinosis caused by hereditary renal hypouricaemia 3 months after kidney transplantation. A 41-year-old man who underwent living-related kidney transplantation from his father was admitted to our hospital for a protocol biopsy; he had a serum creatinine (S-Cr) of 1.37 mg/dL and no proteinuria. Histologically, there was no evidence of rejection or calcineurin inhibitor toxicity, although scattered nephrocalcinosis was observed in the distal tubules. Perioperatively, the patient had a serum uric acid (S-UA) of 1...
July 2016: Nephrology
Eyup Kulah
BACKGROUND: The living kidney donor counseling prior to the operation may be helpful to learn how to properly care for the remaining single kidney for the rest of their lives. Worsening kidney function is associated with elevated serum uric acid (UA) levels. In this study, we compared the baseline laboratory findings of renal transplant donors with their follow-up laboratory values. METHODS: The study consisted of 173 adult donors including 91 females and 82 males with a mean age of 46...
2016: Renal Failure
R C Bello, V A Bello, T T Rosa, L F Junqueira, E Freitas, J P R Veiga
BACKGROUND: The objective of this study was to evaluate renal function and to explore the relationship between some risk factors in kidney donors 12.37 ± 7.60 years after donation. PATIENTS AND METHODS: In a cross-sectional study conducted in a transplant unit, 77 nephrectomized subjects were assessed ≥5 years after donation to evaluate their renal function and the presence or absence of hypertension, dyslipidemia, and microalbuminuria. RESULTS: Twenty donors had an estimated glomerular filtration rate of <60 mL/min/1...
December 2015: Transplantation Proceedings
Alireza Boloori, Soroush Saghafian, Harini A Chakkera, Curtiss B Cook
BACKGROUND: Hyperglycemia following solid organ transplant is common among patients without pre-existing diabetes mellitus (DM). Post-transplant hyperglycemia can occur once or multiple times, which if continued, causes new-onset diabetes after transplantation (NODAT). OBJECTIVE: To study if the first and recurrent incidence of hyperglycemia are affected differently by immunosuppressive regimens, demographic and medical-related risk factors, and inpatient hyperglycemic conditions (i...
2015: PloS One
Guillaume Bollée, Pierre Cochat, Michel Daudon
PURPOSE OF REVIEW: To provide transplant physicians with a summary of the pathogenesis and diagnosis of adenine phosphoribosyl transferase (APRT) deficiency and primary hyperoxaluria and, focussed on kidney transplantation, and to discuss interventions aimed at preventing and treating the recurrence of crystalline nephropathy in renal transplant recipients. SOURCE OF INFORMATION: Pubmed literature search. SETTING: Primary hyperoxaluria and APRT deficiency are rare inborn errors of human metabolism...
2015: Canadian Journal of Kidney Health and Disease
Gianni Bellomo
Evidence is accumulating indicating a role for uric acid in the genesis and progression of kidney disease, and a few studies are beginning to show a possible beneficial effect of urate-lowering therapy. Whether this holds true for renal allograft recipients is not clear. In this short review evidence from epidemiological as well as intervention studies is summarized and discussed, with some practical considerations presented at the end.
July 6, 2015: World Journal of Nephrology
Il Hwan Oh, Jeong Eun Kim, Chang Hwa Lee, Gheun-Ho Kim, Joon-Sung Park
Hyperuricemia following kidney transplantation (KT) may contribute to a decline in allograft renal function, but be affected by KT-related confounding factors. Some studies have even suggested that a reduction in serum uric acid (UA) is associated with poor patient outcomes. Thus, we retrospectively analyzed the impact of serum UA on allograft outcomes in 281 KT recipients. KT recipients were divided into five groups according to serum UA level (mg/dL): Group I (n = 46), ≤ 5; Group II (n = 62), > 5 and ≤ 6; Group III (n = 70), > 6 and ≤ 7; Group IV (n = 53), > 7 and ≤ 8; Group V (n = 50), > 8...
February 2016: Artificial Organs
Anne-Roos S Frenay, Arslan Arinc Kayacelebi, Bibiana Beckmann, Sabita S Soedamah-Muhtu, Martin H de Borst, Else van den Berg, Harry van Goor, Stephan J L Bakker, Dimitrios Tsikas
Renal transplant recipients (RTR) have an increased cardiovascular risk profile. Low levels of circulating homoarginine (hArg) are a novel risk factor for mortality and the progression of atherosclerosis. The kidney is known as a major source of hArg, suggesting that urinary excretion of hArg (UhArg) might be associated with mortality and graft failure in RTR. hArg was quantified by mass spectrometry in 24-h urine samples of 704 RTR (functioning graft ≥1 year) and 103 healthy subjects. UhArg determinants were identified with multivariable linear regression models...
September 2015: Amino Acids
Hideki Uedono, Akihiro Tsuda, Eiji Ishimura, Mari Yasumoto, Mitsuru Ichii, Akinobu Ochi, Yoshiteru Ohno, Shinya Nakatani, Katsuhito Mori, Junji Uchida, Tatsuya Nakatani, Masaaki Inaba
BACKGROUND/AIMS: Hyperuricemia has been reported to affect renal hemodynamics in rat models. We evaluate the relationship between serum uric acid and intrarenal hemodynamic parameters in humans, utilizing the plasma clearance of para-aminohippurate (CPAH ) and inulin (Cin). METHODS: Renal and glomerular hemodynamics were assessed by simultaneous measurement of CPAH and Cin in 58 subjects. Of these, 19 subjects were planned to provide a kidney for transplantation; 26 had diabetes without proteinuria; and 13 had mild proteinuria...
2015: Kidney & Blood Pressure Research
Bernadett Borda, Edit Szederkényi, Csaba Lengyel, Tamás Várkonyi, Zoltán Hódi, Éva Kemény, Viktor Szabó, György Lázár
INTRODUCTION: New-onset diabetes is one of the most common complications after kidney transplantation. AIM: The aims of the authors were to examine the frequency of new-onset diabetes mellitus in kidney transplanted patients receiving cyclosporine A (n = 95) and tacrolimus (n = 102) and to analyze the occurrence of T-cell mediated rejection in these two groups of patients. METHOD: Age, laboratory results, renal function and histological findings were evaluated one year after kidney transplantation...
May 10, 2015: Orvosi Hetilap
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